Hesitation Wounds by Amy Koppelman

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Hardcover, 187 pages

Published: 2015 by The Overlook Press

Setting: New York

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As a teen Susanna Seliger lost her beloved brother, a sensitive, rebellious graffiti artist deeply affected by the death of a young black man in police custody. Her wounds from the loss of her father, when she was a little girl, had never fully healed, and her brother’s death consumed her.

Now, in her mid-forties, she is a psychiatrist specializing in electroconvulsive therapy, the treatment of last resort for patients with severe depression. Since leaving the only man she really loved, in her early twenties, she’s had only stagnant relationships. Like Lainey in I Smile Back, her life is circumscribed by debilitating fear.

This is what I know: the people who love you leave. But you already know that. We all think we know. Yet somehow…at some point we are without. And it’s like walking through life without the sky.

Susanna loses a patient she’s become particularly attached to–the downside to a treatment of last resort is that if it doesn’t work, one loses hope. This jarring experience forces her to face the pain around which her own life revolves and, in the process, explore her hopes. She wants to move forward and become a mother before it’s too late.

Written in a lyrical stream-of-consciousness style, this novel could be described as not so much a narrative as a poem. The plot is not linear–all the thoughts that comprise the book may take place over the course of several hours, or several minutes. This gives it a quality that is both eloquent and raw; we experience the narrator’s immediate, unfiltered emotions. It’s the sort of book in which I focused less on the story than on particular turns of phrase I loved and ways of articulating emotions which resonated with me.

This sad but ultimately hopeful novel will appeal strongly to readers who gravitate toward literary fiction. Amy Koppelman is a brave and extraordinary writer. I love her passion for writing about mental health issues, her well-honed knack for capturing the moment it all unravels, and her gift for exploring the complex, ever-shifting terrain of grief, fear, depression, and hope. Her books, about characters who are very different from me, feel quite personal and intimate and resonate with me in the place where I keep my most private thoughts and experiences.

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